1. What is emergency contraception?

Emergency contraception (EC) is a contraceptive method used by a woman after unprotected sexual intercourse to prevent an unwanted pregnancy.

There are currently two methods of emergency contraception: oral emergency contraceptive pills and the copper-bearing intrauterine device (IUD).

Emergency contraceptive pills (ECPs) are sometimes referred to as "morning-after" or "postcoital" pills, but since these terms do not convey the correct timing for EC use, the preferred term is "emergency contraceptive pills." ECPs should be used within 120 hours (5 days) after unprotected intercourse. [note] Available types of ECPs are:

  • Oral contraceptives containing only progestin (levonorgestrel)

  • Combined oral contraceptives containing an estrogen (ethinyl estradiol) and a progestin (levonorgestrel) - the Yuzpe method

Both of these types are available as dedicated EC products - higher-dose pills that are specially packaged for use as emergency contraception. If dedicated ECPs are not available, then increased doses of regular oral contraceptives are used as EC.

ECPs are not a substitute for regular family planning; Chapter 2 describes how to use ECPs.

A copper-bearing IUD (The Copper T “TCu380A” or Multiload “MLCu-375”) can also be used as EC when inserted within seven days of unprotected intercourse.[note] The IUD can remain in place to serve as a regular contraceptive for up to 5-10 years; it may be removed by a trained health provider whenever the client wishes. Chapter 3 describes how to use a copper-bearing IUD for EC.

2. Who may need to use EC? What are the appropriate uses for EC?

There are several situations in which a woman or girl of reproductive age may need EC to avoid an unwanted pregnancy, as listed below.

  • She has little or no awareness about contraception and has had unprotected sexual intercourse.

  • She desires contraception, has had sexual intercourse and is not currently using regular contraceptive methods.

  • She desires contraception, has had sexual intercourse and used her regular contraceptives incorrectly or inconsistently.

  • She desires contraception and her contraceptive method has failed:
  • condom breakage or slippage
  • failure to abstain from sex during fertile days
  • expulsion of an IUD
  • failure of withdrawal method, when ejaculation has occurred in the vagina or on the external genitalia
  • failure to take oral contraceptives for 2 or more days
  • being late for a contraceptive injection

  • She has been a recent victim of sexual assault and had no contraceptive protection.

While all women in situations of conflict are vulnerable to sexual violence, young female adolescents may be the group most in need of emergency contraceptive services. Adolescent refugees are often targeted for sexual exploitation and rape, yet there are relatively few programs that address the specific reproductive health needs of young people and even fewer that provide EC.

As with all health interventions, EC should be implemented in accordance with the cultural values of refugee communities and host country protocols. EC is one component of reproductive health care and communities need to receive full and impartial information and counseling on it as they do for all other forms of reproductive health care. Health workers may require additional training in EC if they are not familiar with its use, in order to ensure a sensitive and culturally appropriate response to women's needs. Furthermore, service providers who are not familiar with EC protocols in the host country should contact the local Ministry of Health to ensure that EC services are aligned with national laws and policies.

The box below lists all of the countries where dedicated EC products are available; it does not distinguish between countries that are affected by conflict and those that are not. The list excludes countries where dedicated EC products are not yet registered and available, where copper-bearing IUDs may be used for EC, or where EC is prohibited. For more information on EC product availability in a particular country, please go to http://ec.princeton.edu/worldwide/default.asp.


List of Countries with Dedicated EC Products


Source: Consortium for Emergency Contraception. and The Emergency Contraception Website . Last updated 2003.

3. What are the possible consequences of not using EC?

Without EC, women forcibly displaced by conflict may have to endure unplanned or forced pregnancies, unsafe abortions and/or obstetric complications - all of which increase a woman's risk of illness or death. Young women are at a higher risk of negative outcomes because their bodies are not yet fully developed. In addition, women and girls may suffer psychological and emotional consequences without access to EC.



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